Thesis

Challanges and prospects of community-based health insurance in Bangladesh

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Awarding institution
  • University of Strathclyde
Date of award
  • 2024
Thesis identifier
  • T16835
Person Identifier (Local)
  • 201993253
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Department, School or Faculty
Abstract
  • Bangladesh developed a national healthcare financing strategy in 2012 to establish and improve healthcare financing. The strategy proposed social health insurance to attain universal health coverage. Reaching the 56% of the informal sector that has no formal payment system and constantly changes jobs is a huge challenge. This population can contribute to a small amount as a premium, therefore community-based health insurance (CBHI) has been defined as an interim step to plan towards a comprehensive social health insurance system. This thesis examines the need, challenges, and future prospects of voluntary CBHI to contribute to a social health insurance scheme, notably to give financial protection to the informal sector and extend universal coverage. This has been achieved by two quantitative, two qualitative, and one system dynamic research. To determine the need for CBHI for the informal sector and poor, quantitative studies have examined accessibility and financial hardship owing to out-of-pocket healthcare expenditure. Qualitative studies have examined the challenges related to the implementation of voluntary CBHI schemes and ways to overcome them, as well as the political economics barriers to health financing reform in Bangladesh. In addition, a system dynamic study has been carried out to find effective strategies to overcome CBHI implementation challenges and assess their implications.Our findings show that socioeconomically disadvantaged informal sector workers have difficulties getting government healthcare and due to substantial out-of-pocket healthcare spending, many struggle financially following treatment. The targeted social health insurance system is essential for Bangladesh to achieve universal coverage and meet the healthcare needs of this vulnerable population. Bangladesh's biggest challenge is addressing the informal sector, which employs most of the people. To bring the informal sector under the universal coverage, governments must systematically address CBHI implementation challenges and provide technical and financial support to CBHI schemes, learning from international experiences.
Advisor / supervisor
  • Morton, Alec
Resource Type
DOI

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